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<\/li>\n<\/ul>\nDeaths from drug overdose are an increasing public health burden in the United States (1\u20134<\/a>). This report uses the most recent data from the\u00a0National Vital Statistics System (NVSS)<\/a>\u00a0to update trends in drug overdose deaths, describe demographic and geographic patterns, and identify shifts in the types of drugs involved.<\/p>\n <\/p>\n Keywords<\/strong>:\u00a0poisoning, opioids, heroin, National Vital Statistics System Mortality File<\/em><\/p>\n <\/p>\n <\/a>In 2016, the age-adjusted rate of drug overdose deaths in the United States was more than three times the rate in 1999.<\/p>\n <\/p>\n <\/a>Figure 1. Age-adjusted drug overdose death rates: United States, 1999\u20132016<\/p>\n 1<\/sup>Significant increasing trend from 1999 to 2016 with different rates of change over time,\u00a0p<\/em>\u00a0< 0.001. <\/p>\n <\/a>Among persons aged 15 and over, adults aged 25\u201334, 35\u201344, and 45\u201354 had the highest rates of drug overdose deaths in 2016.<\/p>\n <\/p>\n <\/a>Figure 2. Drug overdose death rates, by selected age group: United States, 1999\u20132016<\/p>\n 1<\/sup>Significant increasing trend from 1999 to 2016 with different rates of change over time,\u00a0p<\/em>\u00a0< 0.05. <\/p>\n <\/a>In 2016, 22 states and the District of Columbia had age-adjusted drug overdose death rates that were statistically higher than the national rate.<\/p>\n <\/p>\n <\/a>Figure 3. Age-adjusted drug overdose death rates, by state: United States, 2016<\/p>\n NOTES: Deaths are classified using the International Classification of Diseases, Tenth Revision. Drug-poisoning (overdose) deaths are identified using underlying cause-of-death codes X40\u2013X44, X60\u2013X64, X85, and Y10\u2013Y14.\u00a0Access data table for Figure 3<\/span><\/a>. <\/p>\n <\/a>The age-adjusted rate of drug overdose deaths involving synthetic opioids other than methadone doubled from 2015 to 2016.<\/p>\n <\/p>\n <\/a>Figure 4. Age-adjusted drug overdose death rates, by opioid category: United States, 1999\u20132016<\/p>\n 1<\/sup>Significant increasing trend from 1999 to 2016 with different rates of change over time,\u00a0p<\/em>\u00a0< 0.05. <\/p>\n <\/a>Summary<\/p>\n This report updates statistics on deaths from drug overdoses in the United States and includes information on trends since 1999 as well as key findings for 2016.<\/p>\n The rates of drug overdose deaths continued to increase. In 2016, the age-adjusted rate of drug overdose deaths (19.8 per 100,000) was more than three times the rate in 1999 (6.1). Rates increased for both males (from 8.2 in 1999 to 26.2 in 2016) and females (from 3.9 in 1999 to 13.4 in 2016). Rates also increased for all age groups studied. In 2016, among persons aged 15 and over, rates were highest for adults aged 25\u201334, 35\u201344, and 45\u201354, at about 35 per 100,000. From 2015 to 2016, drug overdose death rates increased 28% for persons aged 15\u201324, 29% for persons aged 25\u201334, 24% for persons aged 35\u201344, 15% for persons aged 45\u201354, 17% for persons aged 55\u201364, and 7% for persons aged 65 and over. In 2016, 22 states and the District of Columbia had age-adjusted drug overdose death rates that were statistically higher than the national rate; 5 states had rates that were comparable to the national rate; and 23 states had lower rates.<\/p>\n The pattern of drugs involved in drug overdose deaths has changed in recent years. The rate of drug overdose deaths involving synthetic opioids other than methadone (drugs such as fentanyl, fentanyl analogs, and tramadol) doubled in a single year from 3.1 per 100,000 in 2015 to 6.2 in 2016. Rates of drug overdose deaths involving heroin increased from 4.1 in 2015 to 4.9 in 2016. Rates of drug overdose deaths involving natural and semisynthetic opioids increased from 3.9 in 2015 to 4.4 in 2016.<\/p>\n <\/p>\n <\/a>Definitions<\/p>\n Drug poisoning (overdose) deaths<\/strong>: Includes deaths resulting from unintentional or intentional overdose of a drug, being given the wrong drug, taking a drug in error, or taking a drug inadvertently.<\/p>\n Natural and semisynthetic opioids<\/strong>: Includes such drugs as morphine, codeine, hydrocodone, and oxycodone.<\/p>\n Synthetic opioids other than methadone<\/strong>: Includes such drugs as fentanyl, fentanyl analogs, and tramadol.<\/p>\n <\/p>\n <\/a>Data source and methods<\/p>\n Estimates are based on the NVSS multiple-cause-of-death mortality files (5<\/a>). Drug poisoning (overdose) deaths were defined as having an International Classification of Diseases, Tenth Revision (ICD\u201310) underlying-cause-of-death code of X40\u2013X44 (unintentional), X60\u2013X64 (suicide), X85 (homicide), or Y10\u2013Y14 (undetermined intent). Of the drug overdose deaths in 2016, 86% were unintentional, 8% were suicides, 6% were of undetermined intent, and less than 1% were homicides. The type of drug(s) involved are indicated by ICD\u201310 multiple-cause-of-death codes: heroin (T40.1), natural and semisynthetic opioids (T40.2), methadone (T40.3), and synthetic opioids other than methadone (T40.4).<\/p>\n Age-adjusted death rates were calculated using the direct method and adjusted to the 2000 standard population (6<\/a>). Differences between national and state estimates were evaluated using two-sided significance tests at the 0.01 level, with the national rate treated as a fixed parameter. Trends in death rates were evaluated using the Joinpoint Regression Program (7<\/a>). Unless otherwise stated, all comparisons described are statistically significant at the 0.05 level of significance.<\/p>\n Several factors related to death investigation and reporting may affect measurement of death rates involving specific drugs. At autopsy, the substances tested for and the circumstances under which the toxicology tests are performed vary by jurisdiction. This variability is likely to affect substance-specific death rates more than the overall drug overdose death rate. The percentage of drug overdose deaths that identified the specific drugs involved varied by year, with ranges of 75%\u201379% from 1999 to 2013, and 81%\u201385% from 2014 to 2016.<\/p>\n Additionally, drug overdose deaths may involve multiple drugs; therefore, a single death might be included in more than one category when describing the rate of drug overdose deaths involving specific drugs. For example, a death that involved both heroin and fentanyl would be included in both the rate of drug overdose deaths involving heroin and the rate of drug overdose deaths involving synthetic opioids other than methadone.<\/p>\n <\/p>\n <\/a>About the authors<\/p>\n Holly Hedegaard is with the National Center for Health Statistics (NCHS), Office of Analysis and Epidemiology. Margaret Warner and Arialdi M. Mini\u00f1o are with the NCHS Division of Vital Statistics.<\/p>\n <\/p>\n <\/a>References<\/p>\n <\/p>\n\n
![\"Figure](\"https:\/\/www.cdc.gov\/nchs\/images\/databriefs\/251-300\/db294_fig1.gif\")
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\n2<\/sup>2016 rate for males was significantly higher than for females,\u00a0p<\/em>\u00a0< 0.001.
\nNOTES: Deaths are classified using the International Classification of Diseases, Tenth Revision. Drug-poisoning (overdose) deaths are identified using underlying cause-of-death codes X40\u2013X44, X60\u2013X64, X85, and Y10\u2013Y14. The number of drug overdose deaths in 2016 was 63,632.\u00a0Access data table for Figure 1<\/span><\/a>.
\nSOURCE: NCHS, National Vital Statistics System, Mortality.<\/p>\n\n
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\n2<\/sup>2016 rate was significantly higher than for the rate for age groups 15\u201324, 55\u201364, and 65 and over,\u00a0p<\/em>\u00a0< 0.05.
\nNOTES: Deaths are classified using the International Classification of Diseases, Tenth Revision. Drug-poisoning (overdose) deaths are identified using underlying cause-of-death codes X40\u2013X44, X60\u2013X64, X85, and Y10\u2013Y14.\u00a0Access data table for Figure 2<\/span><\/a>.
\nSOURCE: NCHS, National Vital Statistics System, Mortality.<\/p>\n\n
![\"Figure](\"https:\/\/www.cdc.gov\/nchs\/images\/databriefs\/251-300\/db294_fig3.gif\")
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\nSOURCE: NCHS, National Vital Statistics System, Mortality.<\/p>\n\n
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\n2<\/sup>Significant increasing trend from 1999 to 2006, then decreasing trend from 2006 to 2016,\u00a0p<\/em>\u00a0< 0.05.
\nNOTES: Deaths are classified using the International Classification of Diseases, Tenth Revision. Drug-poisoning (overdose) deaths are identified using underlying cause-of-death codes X40\u2013X44, X60\u2013X64, X85, and Y10\u2013Y14. Drug overdose deaths involving selected drug categories are identified by specific multiple-cause-of-death codes: heroin, T40.1; natural and semisynthetic opioids, T40.2; methadone, T40.3; and synthetic opioids other than methadone, T40.4. Deaths involving more than one opioid category (e.g., a death involving both methadone and a natural or semisynthetic opioid) are counted in both categories. The percentage of drug overdose deaths that identified the specific drugs involved varied by year, with ranges of 75%\u201379% from 1999 to 2013, and 81%\u201385% from 2014 to 2016.\u00a0Access data table for Figure 4<\/span><\/a>.
\nSOURCE: NCHS, National Vital Statistics System, Mortality.<\/p>\n\n